An anesthesiologist expressed the belief here Friday that when a surgeon is repairing an injury, involving a limited area of the body, a local anesthetic is safer.
Not only is a local anesthetic safer than a general anesthetic in such cases, said Dr. Kenneth Bray, it's use can also be of help to the surgeon.
“Say a surgeon is attempting to restore function to an injured hand,” said Dr. Bray, who heads the anesthesiology department at Veterans Administration Hospital. “It can sometimes be a big help to him if, during surgery, he can turn to the patient and say ‘See if you can move your third finger.’ I the patient can, then the surgeon knows his surgery is progressing as desired. This of course is not possible with ; general anesthetic.”Dr. Bray was one of the speakers at the Postgraduate Course in Anesthesiology held at Tulane School of Medicine, under the auspices of the division of postgraduate medicine at Tulane.
BLOCK PAIN IMPULSES
The anesthesiologist told those attending the conference that when a local anesthetic is used during surgery for say a crushing injury of the forearm, the resulting anesthesia blocks pain impulses and keeps them from going into the central nervous system.
“It also prevents such undesirable reflexes as cardiac and respiratory changes,” added Dr. Bray, who is also assistant clinical professor of anesthesiology at Louisiana State University Medical school.
The speaker said use of a local anesthesia will cause the muscles to relax in the limited area on which surgery is to be performed.
Naturally a local anesthetic cannot be used if injuries are too extensive,” he explained.
“But it is certainly the anesthetic of choice for injuries involving a limited area,” he added, “Its value in war areas has been repeatedly demonstrated.”
Asked if he considered it advisable to use a “local,” on highly nervous patients, Dr. Bray said under today’s setup it is perfectly permissible.
“Today when such a patient is being prepared for surgery, he is given a drug which sedates him and makes him comfortable,” the physician explained,” As a result we do not have to worry over the fact that the patient will be conscious during surgery.”
MINIMUM DESIRABLE Dr. Bray said “today it is generally agreed that the minimum anesthesia compatible with the satisfactory performance of surgery and the welfare of the patient is highly desirable.”
The anesthesiologist then discussed the use of a hypothermia machine during surgery involving a head injury.
“This machine lowers the amount of blood and decreases the oxygen requirements of the brain and other structures,” he explained.
Another speaker discussed ways and means of increasing the safety of spinal anesthesia used during a Cesarean section.
Dr. David Barclay said although he considers spinal anesthesia one of the best forms of anesthesia for a Cesarean section, “it is not well accepted in some parts of the country.” “Why? Because it has been
used by people not well versed in the physiological changes which take place in a person’s body whenever a ‘spinal’ is administered,” the physician explained.
Dr. Barclay, who is assistant professor of obstetrics and gynecology at Tulane University Medical school, said “whenever a spinal anesthetic is administered there is a tendency for blood pressure to decrease.”
“This tendency is exaggerated during pregnancy because the large uterus fills the abdomen and compresses the veins,” the obstetrician explained.
Dr. Barclay said preliminary investigation indicates that the effect of this compression can be nullified by the use of a plastic leg compression apparatus, prior to the administration of the spinal anesthetic.
“As a result,” he explained, “the incidence of decreased blood pressure during spinal anesthesia for certain Cesarean sections has been significantly lowered.”
Dr. Barclay said because this is true it is not necessary to use as many drugs to elevate blood pressure as was formerly the case.
He said in more than 80 per cent of the cases, the blood pressure has been brought back to normal with the use of the compressor or “legging” as it is called.
Dr. John Adriani, professor of the department of surgery, (anesthesiology) for Tulane Medical School, served as program chairman.
PHOTO CAPTION READS:
THREE SPEAKERS at the Postgraduate Course in Anesthesiology at Tulane University School of Medicine Friday inspect a hypothermia unit, which is used in cases involving head injuries. From left are Dr. David Barclay, assistant professor of obstetrics and gynecology, Tulane; Dr. Kenneth Bray, clinical professor of anesthesia, Louisiana $ate University, and Dr. John Adriana, professor in the Department of Surgery (Anesthesiology) at Tulane, who served as program chairman.

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An anesthesiologist expressed the belief here Friday that when a surgeon is repairing an injury, involving a limited area of the body, a local anesthetic is safer.
Not only is a local anesthetic safer than a general anesthetic in such cases, said Dr. Kenneth Bray, it's use can also be of help to the surgeon.
“Say a surgeon is attempting to restore function to an injured hand,” said Dr. Bray, who heads the anesthesiology department at Veterans Administration Hospital. “It can sometimes be a big help to him if, during surgery, he can turn to the patient and say ‘See if you can move your third finger.’ I the patient can, then the surgeon knows his surgery is progressing as desired. This of course is not possible with ; general anesthetic.”Dr. Bray was one of the speakers at the Postgraduate Course in Anesthesiology held at Tulane School of Medicine, under the auspices of the division of postgraduate medicine at Tulane.
BLOCK PAIN IMPULSES
The anesthesiologist told those attending the conference that when a local anesthetic is used during surgery for say a crushing injury of the forearm, the resulting anesthesia blocks pain impulses and keeps them from going into the central nervous system.
“It also prevents such undesirable reflexes as cardiac and respiratory changes,” added Dr. Bray, who is also assistant clinical professor of anesthesiology at Louisiana State University Medical school.
The speaker said use of a local anesthesia will cause the muscles to relax in the limited area on which surgery is to be performed.
Naturally a local anesthetic cannot be used if injuries are too extensive,” he explained.
“But it is certainly the anesthetic of choice for injuries involving a limited area,” he added, “Its value in war areas has been repeatedly demonstrated.”
Asked if he considered it advisable to use a “local,” on highly nervous patients, Dr. Bray said under today’s setup it is perfectly permissible.
“Today when such a patient is being prepared for surgery, he is given a drug which sedates him and makes him comfortable,” the physician explained,” As a result we do not have to worry over the fact that the patient will be conscious during surgery.”
MINIMUM DESIRABLE Dr. Bray said “today it is generally agreed that the minimum anesthesia compatible with the satisfactory performance of surgery and the welfare of the patient is highly desirable.”
The anesthesiologist then discussed the use of a hypothermia machine during surgery involving a head injury.
“This machine lowers the amount of blood and decreases the oxygen requirements of the brain and other structures,” he explained.
Another speaker discussed ways and means of increasing the safety of spinal anesthesia used during a Cesarean section.
Dr. David Barclay said although he considers spinal anesthesia one of the best forms of anesthesia for a Cesarean section, “it is not well accepted in some parts of the country.” “Why? Because it has been
used by people not well versed in the physiological changes which take place in a person’s body whenever a ‘spinal’ is administered,” the physician explained.
Dr. Barclay, who is assistant professor of obstetrics and gynecology at Tulane University Medical school, said “whenever a spinal anesthetic is administered there is a tendency for blood pressure to decrease.”
“This tendency is exaggerated during pregnancy because the large uterus fills the abdomen and compresses the veins,” the obstetrician explained.
Dr. Barclay said preliminary investigation indicates that the effect of this compression can be nullified by the use of a plastic leg compression apparatus, prior to the administration of the spinal anesthetic.
“As a result,” he explained, “the incidence of decreased blood pressure during spinal anesthesia for certain Cesarean sections has been significantly lowered.”
Dr. Barclay said because this is true it is not necessary to use as many drugs to elevate blood pressure as was formerly the case.
He said in more than 80 per cent of the cases, the blood pressure has been brought back to normal with the use of the compressor or “legging” as it is called.
Dr. John Adriani, professor of the department of surgery, (anesthesiology) for Tulane Medical School, served as program chairman.
PHOTO CAPTION READS:
THREE SPEAKERS at the Postgraduate Course in Anesthesiology at Tulane University School of Medicine Friday inspect a hypothermia unit, which is used in cases involving head injuries. From left are Dr. David Barclay, assistant professor of obstetrics and gynecology, Tulane; Dr. Kenneth Bray, clinical professor of anesthesia, Louisiana $ate University, and Dr. John Adriana, professor in the Department of Surgery (Anesthesiology) at Tulane, who served as program chairman.